JOB PURPOSE 

Responsible for the identification, analysis and resolution of non-clinically based underpayments and denials, and initiating appeals between Cottage Health and outside payers. The analyst will work with revenue cycle and clinical departments within Cottage Health, and third party payors' provider representatives to identify the source of denials and develop processes to eliminate and/or minimize denials/underpayments and rejections to improve cash flow. The non-clinical denials analyst works denied and underpaid accounts to obtain full reimbursement for services provided and identify denial and underpayment root causes.

QUALIFICATIONS 

All job qualifications listed indicate the minimum level necessary to perform this job proficiently. 

LEVEL OF EDUCATION 

Minimum: N/A 

Preferred: Associate's degree 

CERTIFICATIONS, LICENSES, REGISTRATIONS 

Minimum: N/A Preferred: Epic Certified or trained if on Professional Billing team. 

TECHNICAL REQUIREMENTS 

Minimum: Basic user of MS Outlook, Word and Excel. Ability to navigate payor websites and CMS manuals. 

Preferred: Experience with Epic Reporting and analysis if on Professional Billing team. 

YEARS OF RELATED WORK EXPERIENCE 

Minimum: 2 years of professional billing/collections revenue cycle experience (professional billing experience required if on Professional Billing team), with at least one of those years working with denials and appeals. 

Preferred: 3 years working with denials and appeals, in an acute care setting. 1 year supervisory experience